Ventilator-associated pneumonia (VAP) is an infection of the lungs that affects people who are on mechanical ventilation. Mechanical ventilation is done with a machine that helps you breathe. Pneumonia affects the small airways and air sacs in the lungs.
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VAP is commonly caused by specific bacteria.
The tube that goes into the lungs makes it easier for bacteria to enter deep into the lungs.
Factors that may increase your chance of VAP include: Chronic lung diseaseConditions that affect the nervous systemWeakened immune systemProlonged antibiotic useRepeated intubationTube placed through a stoma (hole in the throat) rather than down through the nose or mouthProlonged ventilationContinuous sedationProlonged period of lying on backMalnutritionOlder age
VAP may cause: FeverChillsCoughThick mucus, greenish mucus, or pus-like phlegmBluish color of nails or lipsNausea or vomitingShortness of breath
Your doctor will review your symptoms and medical history. A physical exam will also be done. Tests may include: Blood tests, which may include arterial blood gases to measure oxygen, carbon dioxide, and acid in the bloodBlood culturesCultures from below the chest tubeChest x-rayCT scan
Treatment depends on which germs are causing the pneumonia. Your doctor will discuss the best treatment plan with you. Treatment options include: IV antibioticsOxygen therapy to increase the level of oxygen in your bodyChest physical therapy to loosen and remove thick mucus from the lungs
To reduce your chance of VAP, the healthcare team will: Elevate the head of your bed 30°-45°Wash their hands before and after touching you or the ventilatorClean the inside of your mouth on a regular basisKeep you on the ventilator only if it is necessaryAvoid overly sedating youRegularly suction your airway
American Thoracic Society. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia.
Am J Respir Crit Care Med. 2005;171(4):388-416.
Ventilator-associated pneumonia. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/HAI/vap/vap.html. Updated May 17, 2012. Accessed February 17, 2014.
Koenig SM, Truwit JD. Ventilator-associated pneumonia: Diagnosis, treatment, and prevention.
Clin Microbio Rev. 2006;19(4):637-657.
Society for Healthcare Epidemiology of America. FAQs about ventilator-associated pneumonia. Society for Healthcare Epidemiology of America website. Available at:
http://www.shea-online.org/Assets/files/patient%20guides/NNL_VAP.pdf. Accessed February 17, 2014.
Ventilator-associated pneumonia. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated December 2, 2013. Accessed February 17, 2014.
Last reviewed February 2015 by David L Horn, MD, FACP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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